The Rector of MU-Pleven Prof. Dr. Dobromir Dimitrov, in his capacity as Chairman of the Association of Medical Universities in Bulgaria, initiated on March 10 the first meeting-discussion to discuss the problems in the admission and education of students in the specialties in the field of Health Care. Emphasis was placed on the need to increase the prestige and attractiveness of the professions "Nurse", "Midwife", "Assistant Pharmacist", "Medical Assistant".
Alexander Alexandrov, Chairman of the Bulgarian Union of Medical Assistants and Paramedics (BULAF) and Galina Zaharieva, Deputy Chairman of BULAF, spoke about the problems and professional challenges in the field in Our Day.
Zaharieva states: "The shortage of staff is a global problem – it is not only in Bulgaria. In 2021, there was a deficit of about 2 million medical professionals in European health care. The lack of medical professionals outside the country is the reason many of ours leave and go there, as there are better working conditions.
According to the Deputy Chairman of BULAF, there are many problems in Bulgaria, some of which are related to education – insufficient investment in the training of specialists, constant change in curricula and educational programmes, the professional status of trainees, changes in the time for obtaining a degree.
Alexandrov points out that before the reforms, paramedics covered small settlements and remote areas well. The healthcare system was saturated with quality, qualified healthcare personnel in the face of paramedics. After 2000, when the new system came into operation, the offices of general practitioners were established to replace paramedics. According to the Bulgarian legislation, healthcare should be equal and on one level everywhere, so the rule has been introduced that people must be examined by doctors instead of paramedics (medical assistants). According to Alexandrov, the problem is that doctors prefer to stay in the city and so a large number of people do not receive medical care – a serious gap in healthcare.
Six universities currently train medical assistants. Unfortunately, there are few, but there is an interest in the profession. We already have talks with the Association of Rectors to increase the number and number of universities, because it turned out that in the central part of Northern Bulgaria there is no university to train such staff and their deficit in the medical institutions in this region is tangible. There remains the problem of the attractiveness of the profession in terms of subsequent realization", says Zaharieva.
Today, the paramedic is equated to a doctor's assistant. Legally, the paramedic enjoys the rights of a doctor's assistant, but the doctor's assistant does not have the rights yet. The paradox is due to regulatory turmoil, in Zaharieva’s words, which gives the example of the Ordinance on the establishment of death, according to which paramedics have the right to issue a report of death, but medical assistants do not, as they do not appear there.
European society is ageing, which leads to the need for long-term treatment of a number of patients, Zaharieva emphasizes. However, for doctors, this type of activity is not attractive – they are interested in the active phase of treatment. That is why in almost all areas of healthcare, medical assistants can be introduced to engage in routine medical practices and facilitate the work of doctors in hospitals.
Alexandrov adds that the lost connection between the general practitioner and the hospital can be made precisely by the medical assistants.
Currently, medical assistants are the main unit in the emergency medical centers and cannot be replaced by paramedics due to the specifics of the Bulgarian emergency system, Alexandrov believes.
"The medical assistant, going to one address in a sick person, performs a wide volume of medical activities that replace to some extent the activity of the general practitioner. This assistant can take the patient with an ambulance for treatment in a hospital, but can provide appropriate medical care on the spot, give medicine at home. In the West, the paramedic takes the patient to the ambulance and transports him to the hospital in any case," Aleksandrov said.
The full participation of Alexander Alexandrov and Galina Zaharieva can be heard on the sound file via the button below:
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